Thread veins or spider veins are the little blue, purple or red veins that are visible just underneath the skin. Whilst they are not medically dangerous, they are very unpopular, especially with women, because they look so unsightly.
A lot of women feel very self-conscious about their thread veins – to the extent that they wont go out in public in knee length shorts or skirts, and feel embarrassed about wearing swimming costumes.
What are thread veins?
Thread veins are dilated tiny blood vessels just underneath the skin surface. Almost every woman makes thread veins throughout her life – we think that this has something to do with the effect of female hormones on the skin.
Some women make more thread veins than others, but almost all women have a few! Thread veins may be present as well as larger varicose veins, or they can be present in isolation.
How are they treated?
We think the best way to treat thread veins is by injection sclerotherapy. This technique requires us to insert a very tiny needle into the very tiny vein and inject a chemical into it called a sclerosant.
A sclerosant is a chemical which damages the inside of the vein and makes it block up. Initially the vein looks quite bruised but eventually the vein fades and disappears.
After treatment a bandage is applied to compress the veins a little and then a stocking is helpful for a week or so afterwards.
How many treatments will I need?
That depends on how many thread veins you have and how treatment goes. Most patients will have between 2 and 4 treatments, each lasting about 20 minutes. The thing that limits treatment is the dose of the sclerosant drug we are allowed to use at any one time. We usually see patients every week or two until all the veins have been injected.
How much does sclerotherapy cost?
Sclerotherapy costs from £55 per session, so the total cost will depend on the size of the area and how many times you need to come and see us. We can give you a pretty accurate estimate when we see you the first time as we have a lot of experience of this procedure.
Will it hurt?
No! The injections are made using a very tiny needle and most patients barely feel it. The nearest comparison is to acupuncture. Sometimes it feels a bit itchy immediately after treatment and a bit tender for a day or two after, so some patients need to use anti – inflammatory cream.
What can I do after treatment?
You can do pretty much anything after treatment, although as you will have a bandage on, going to the gym is impractical and you will need to avoid showering for a few days while the bandage is on. It is a very simple ‘walk in / walk out procedure’.
What are the risks?
Fortunately there are very few risks from sclerotherapy. There is a theoretical risk of a deep vein thrombosis but we have personally never seen this.
About 1 in 10,000 patients are allergic to the chemical we use.
Occasionally some patients get little blisters on the skin after the injections which can scab over like a tiny sore before healing up.
The worst thing is usually the bruising afterwards – this lasts for 2 or 3 months on average and can last longer. For this reason we recommend that patients don’t have sclerotherapy immediately before holidays for example. A lot of patients like to have sclerotherapy in the autumn or winter time so that when the summer comes their bruises have all faded.
In very rare cases some patients can develop really tiny red thread veins after sclerotherapy. This is called ‘telangectatic matting’. We have rarely seen this in our patients.
How can I make the bruises go away?
For bigger bruises we will let out some of the trapped blood under the skin after about 2 weeks. This speeds up the healing. We recommend use of Arnica cream and Vitamin E Oil on the bruises as well.
What is the chemical you use?
There are several drugs that can be used for sclerotherapy. We use a drug called Fibro vein – its chemical name is Sodium Tetradecyl. This is the commonest drug used in the UK for treatment of thread veins and is fully licenced for this use.
Fibrovein is actually a detergent by its chemical nature. The drug acts by damaging the inside lining of the vein and makes it seal up. Fibrovein is deactivated by contact with proteins in the blood, so we need to make a few injections along the vein in order to be sure that it will work properly
Can my thread veins come back again?
Sadly yes they can – you will continue to make thread veins throughout your life. However, they usually come back slowly, so most of our patients will come back to see us every 18 months or so to keep on top of things.
Are there any other ways of treating thread veins?
Yes – we can use skin lasers or light treatments for thread veins.
The exception is really tiny red veins that we cant get a needle into. For these veins, skin lasers are very useful.